| NPI | 1053775890 |
|---|---|
| Doing Business As | JEFFERSON DENTAL CLINICS |
| Entity Type | Organization |
| Authorized Contact | TIFFANIE N SMITH Credentialing Manager 469-658-8979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31642) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 31642) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2024-03-18 |